Bcl-2 May Contribute to Evolution of Endometrial Hyperplasia, but It Isn’t a Factor in Subsequent Carcinogenesis

ABSTRACTEndometrial carcinoma is common in the western world and is increasing in frequency in developing countries as well. Endometrial hyperplasia is considered to be a precancerous lesion. Apoptosis plays an important role in the neoplastic transformation of cells, with Bcl-2 being an anti-apoptotic cellular marker. Bcl-2 may have an important contribution to the development of endometrial carcinoma. The aim was to evaluate and compare the expression of markers Bcl-2 through the spectrum of normal endometrium, endometrial hyperplasias and endometrial adenocarcinomas. 50 cases were included in this study, comprising of 10 cases of normal endometrium, 10 cases of endometrial hyperplasia without atypia, 10 cases of atypical endometrial hyperplasia and 20 cases of endometrial adenocarcinomas from January 2017 to June 2018. Immunohistochemical staining with Bcl-2 was performed and the results were analyzed.Bcl-2 staining showed an increase in cases with strong intensity of staining from normal endometrium (20% cases) to cases of endometrial hyperplasia (75% cases). There was, however a decrease in the number of cases with strong intensity Bcl-2 staining as the lesions progressed from endometrial hyperplasia to endometrial carcinoma (30% cases). The results were statistically significant (P =0.00309). However, there was no significant association of staining between atypical hyperplasia and endometrial carcinomas (p=0.429), as well as the degree of carcinoma (p=0.6903).Bcl-2 expression showed an increase from cases of normal endometrium to endometrial hyperplasia supporting the process of increased anti- apoptotic activity in endometrial hyperplastic lesions. Its decreased expression in endometrioid adenocarcinoma when compared to endometrial hyperplasias could point towards other mechanisms of carcinogenesis other than failure of apoptosis.

Bcl-2 May Contribute to Evolution of Endometrial Hyperplasia, but It Isn’t a Factor in Subsequent Carcinogenesis Keywords:

Bcl-2 , Endometrium , Endometrial hyperplasia , Endometrial hyperplasia with atypia , Endometrial carcinoma